Virtual reality-based paediatric interactive therapy system (PITS) for improvement of arm and hand function in children with motor impairment—a pilot study

Objective: Rehabilitation of upper-limb sensorimotor function in children with motor dysfunctions is primarily based on movement training. This study developed a virtual-reality based, paediatric interactive therapy system (PITS) that allows children to practice specific movements of the upper limbs with immediate feedback about their motor performance.

Methods: The system was tested on five children with motor dysfunctions over 3 weeks of training. Pre- and post-assessment was conducted before and after the training period.

Results: Results of the pilot study show improvements of hand function in the test scores (except one patient). Patient motivation was high and maintained over the course of the therapy sessions.

Conclusion: PITS is an applicable VR-system which can be feasibly applied during the rehabilitation of children with upper limb motor dysfunctions. Further investigation is necessary to determine if the system provides significantly improved results compared to conventional therapies, both in terms of motor function outcomes and patient motivation.     

Muscular Reconstruction and Functional Morphology of the Forelimb of Early Miocene Sloths (Xenarthra,Folivora) of Patagonia

Early Miocene sloths are represented by a diversity of forms ranging from 38 to 95 kg, being registered mainly from Santacrucian Age deposits in southern‐most shores of Patagonia, Argentina. Their postcranial skeleton differs markedly in shape from those of their closest living relatives (arboreal forms of less than 10 kg), Bradypus and Choloepus. In order to gain insight on functional properties of the Santacrucian sloths forelimb, musculature was reconstructed and a comparative, qualitative morphofunctional analysis was performed, allowing proposing hypotheses about biological role of the limb in substrate preferences, and locomotor strategies. The anatomy of the forelimb of Santacrucian sloths resembles more closely extant anteaters such as Tamandua and Myrmecophaga, due to the robustness of the elements, development of features related to attachment of ligaments and muscles, and conservative, pentadactylous, and strong‐clawed manus. The reconstructed forelimb musculature was very well developed and resembles that of extant Pilosa (especially anteaters), although retaining the basic muscular configuration of generalized mammals. This musculature allowed application of powerful forces, especially in adduction of the forelimb, flexion and extension of the antebrachium, and manual prehension. These functional properties are congruent with both climbing and digging activities, and provide support for proposed Santacrucian sloths as good climbing mammals, possibly arboreal or semiarboreal, being also capable diggers. Their climbing strategies were limited, thus these forms relied mainly on great muscular strength and curved claws of the manus to move cautiously on branches. Anat Rec, 2013. © 2012 Wiley Periodicals, Inc.     

Durability of bond between an indirect composite veneering material and zirconium dioxide ceramics

Abstract

Objective. The purpose of the present study was to evaluate the durability of bond strength between an indirect composite material and zirconia ceramics after thermocycling (100 000 cycles) and to assess the effect of various priming agents for zirconia surface treatments. Materials and methods. A CAD/CAM system (Katana, Noritake Dental Supply) was used to fabricate 96 zirconia disks as a bonding substrate. The specimens were randomly divided into six groups (n = 16) and treated with one of the following acidic priming agents: Alloy Primer (ALP, Kuraray), Clearfil Ceramic Primer (CCP, Kuraray), Clearfil Photo Bond (CPB, Kuraray), Clearfil Photo Bond with Clearfil Porcelain Bond Activator (CPB + Activator, Kuraray), Estenia Opaque Primer (EOP, Kuraray) and Porcelain Liner M Liquid A (PLA, Sun Medical). The specimens were bonded with an indirect composite material (Estenia C&B Dentin, Kuraray). Shear bond strengths were tested before and after 100 000 thermocycles and the data were analyzed by using the Steel-Dwass test and Mann-Whitney U-test. Results. After 100 000 thermocycles, the PLA group showed the lowest bond strength (p = 0.010), whereas the CPB + Activator (23.9 MPa; p < 0.014) and CPB (22.7 MPa; p < 0.028) groups had significantly higher bond strengths than the other groups. The Mann-Whitney U-test revealed that bond strengths did not significantly decrease after thermocycling, except for specimens in the PLA (p = 0.038) and CCP (p = 0.028) groups. Conclusions. Application of a combination of hydrophobic phosphate monomer (MDP) and initiator results in a durable long-term bond between Katana zirconia and Estenia C&B composite material.     

咬合支持丧失患者修复前后咀嚼肌表面肌电分析

目的：探讨咬合支持丧失患者修复前后咀嚼肌肌电的变化。方法：对24例咬合支持丧失患者进行常规修复,记录不同时期双侧咬肌和颞肌前束在下颌姿势位及牙尖交错紧咬位时的肌电活动,分析肌电幅值、不对称指数及咬肌/颞肌活动指数的变化。结果：（1）修复前后下颌姿势位肌电变化,咬肌肌电幅值和不对称指数在不同时期无明显变化（P〉0.05）;颞肌肌电幅值和不对称指数在义齿戴用3个月以上后显著小于义齿早期（P〈0.05）;咬肌/颞肌前束活动指数在各时期均小于0。（2）修复后牙尖交错位紧咬时肌电变化,咬肌及颞肌前束肌电幅值在戴牙3个月后显著高于戴牙早期（P〈0.05）;不对称指数与初戴牙时接近（P〉0.05）,较戴牙1周及1个月显著减小（P〈0.05）。咬肌/颞肌前束活动指数值在各时期均接近0。结论：咬合支持丧失患者进行咬合重建过程中,咀嚼肌肌电活动在不同时期有所变化。肌电测量可为咬合重建效果的评价提供参考。     

Prosthetic Rehabilitation,Implant Survival and Quality of Life 2 to 5 Years after Resection of Oral Tumors

Background: After oral tumor resection, structural and functional rehabilitation by means of dental prostheses is complex, and positive treatment outcome is not always predictable. Purpose: The objective of the study was to report on oral rehabilitation and quality of life 2–5 years after resection of malignant oral tumors. Materials and Methods: Data of 46 patients (57 ± 7 years) who underwent oral tumor surgery were available. More than 50% of tumors were classified T3 or T4. Open oro‐nasal defects resulted in 12 patients and full mandibulary block resections in 23 patients. Comprehensive planning, implant placement, and prosthetic rehabilitation followed an interdisciplinary protocol. Analysis comprised tumor location, type of prostheses, implant survival, and quality of life. Results: Because of advanced tumor status, resections resulted in marked alteration of the oral anatomy requiring complex treatment procedures. Prosthetic rehabilitation comprised fixed and removable prostheses, with 104 implants placed in 28 patients (60%). Early implant loss was high (13%) and cumulative survival rate of loaded implants was <90% after 5 years. Prosthetic plans had to be modified because of side effects of tumor therapy, complications with implants and tumor recurrence. The majority of patients rated quality of life favorable, but some experienced impaired swallowing, dry mouth, limited mouth opening, appearance, and soreness. Conclusions: Some local effects of tumor therapy could not be significantly improved by prosthetic rehabilitation leading to functional and emotional disability. Many patients had passed away or felt too ill to fill the questionnaires. This case series confirms the complex anatomic alterations after tumor resection and the need for individual treatment approaches especially regarding prosthesis design. In spite of disease‐related local and general restrictions, most patients gave a positive assessment of quality of life.     

Asian consensus report on functional dyspepsia

Background and Aim: Environmental factors such as food, lifestyle and prevalence of Helicobacter pylori infection are widely different in Asian countries compared with the West, and physiological functions and genetic factors of Asians may also be different from those of Westerners. Establishing an Asian consensus for functional dyspepsia is crucial in order to attract attention to such data from Asian countries, to articulate the experience and views of Asian experts, and to provide a relevant guide on management of functional dyspepsia for primary care physicians working in Asia. Methods: Consensus team members were selected from Asian experts and consensus development was carried out by using a modified Delphi method. Consensus teams collected published papers on functional dyspepsia especially from Asia and developed candidate consensus statements based on the generated clinical questions. At the first face‐to‐face meeting, each statement was reviewed and e‐mail voting was done twice. At the second face‐to‐face meeting, final voting on each statement was done using a keypad voting system. A grade of evidence and strength of recommendation were applied to each statement according to the method of the GRADE Working Group. Results: Twenty‐nine consensus statements were finalized, including seven for definition and diagnosis, five for epidemiology, nine for pathophysiology, and eight for management. Algorithms for diagnosis and management of functional dyspepsia were added. Conclusions: This consensus developed by Asian experts shows distinctive features of functional dyspepsia in Asia and will provide a guide to the diagnosis and management of functional dyspepsia for Asian primary care physicians.